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In medicine, rapid changes in information, technology, socio-economic interests, and globalization affect the medical education focused on the competencies of doctors, and the number of medical schools that are adopting an outcome-based curriculum (OBC) is increasing worldwide. This paper introduces the OBC model of 5 trailblazing medical schools from the UK, US, and Australia, comparing their unique features, followed by brief comment about Canada and the EU as well. On developing an OBC, the process of establishing the top outcomes for graduates is similar and the outcomes comprise knowledge, skills, and attitudes about science, patients, colleagues, society, and themselves. Implementing the outcomes down into the sub-levels of the curriculum is much more complicated and time-consuming. Assessing the achievement of every outcome is essential and requires the use of many tools in addition to the traditional written examination. From the perspective of adult learning theory, self-directed learning, team-learning, and individual and flexible achievement are tested and executed in an OBC. The gradual expansion and further innovation of an OBC is expected so that tomorrow's doctors will be able to meet the challenges of the future.
Observation of the current Korean medical education and training system shows that certain negative traits of unchangeable solidification engraft themselves so deeply into the overarching system that they are now hampering the state of the national health welfare. Focusing only on undergraduate medical education, we can point out some glaring side-effects that should be of concern to any stakeholder. For instance, a graduate can legally begin his career as an independent practitioner immediately after passing the licensing exam and return to the old stuck school-year system of 2-year-premedical and 4-year-medical programs where outcome-based and integrated curricula are incomplete and unsatisfactory. In terms of learning opportunities, the balance between patient care and public health, as well as that between in-hospital highly specialized practice and community-based general practice, has worsened. Every stakeholder should be aware of these considerations in order to obtain the insight to forge a new direction. Moreover, our medical schools must prepare our students to take on the global roles of patient care within the Fourth Industrial Revolution, health advocacy for the imminent super-aged society, and education and research in the bio-health industry, by building and applying the concept of academic medicine. We will need to invest more resources, including educational specialists, into the current undergraduate medical education system in order to produce proper outcomes, smart curriculum, innovative methods of teaching and learning, and valid and reliable monitoring and evaluation. The improved quality of undergraduate medical education is the starting point for the success of the national system for public health and medical care as a whole, and therefore its urgency and significance should be emphasized to the public. The medical society should go beyond fixing what is broken and usher in a new era of cooperation and collaboration that invites other health professionals, governmental partners, law-makers, opinion leaders, and the general public in its steps toward the future.
Subannular aortic aneurysm is a word-wide rare disease entity occurring predominantly in young black men. In Korea, there has been no report. We report one patient, 46 years old man, who had been operated urgently because of acute aortic insufficiency and aortic valvular vegetation after antibiotics treatment of Subacute bacterial endocarditis for 6wks. At the operative field, We found the bulging aneurysmal mass between the aorta and superior vena cava above the right pulmonary artery, which has subannular communicating opening into the left ventricular cavity, beneath the anterior commissure of the bicuspid aortic valve. Pathologic findings are consistent with "portion of vascular wall with features of aneurysm.* The patients survived aortic valve replacement and patch closure of subannular aneurysm, with no symptoms at one-year postoperative follow-up.w-up.
본 논문은 중국의 주식시장과 외환시장 간의 인과관계, 장기적 균형관계 및 가격이전효과(price spillover effect)와 변동성이전효과(volatility spillover effect)를 분석하였다. 기간은 2000년부터 2009년 말까지 일별자료를 사용하였으며, 2005년 7월 21일부터 실시된 위안화 환율기제 시행 전·후를 각각 1, 2기로 나누어 분석하였다. 분석은 그랜저 검정을 통해 인과성을 검토한 후 VAR 모형을 바탕으로 충격반응함수를 도출하고 E-GARCH 모형을 통해 가격 및 변동성 이전효과를 살펴봄으로써 최근 위안화 환율절상의 가능성과 주식시장과 외환시장 상호간 연계성을 판단해 보았다. 분석결과 위안화 환율기제 개혁 이후부터 외환시장에서 주식시장으로의 선행적 인과성이 나타났으며, 충격반응함수로 추정 결과 환율이 상승할 때 주가도 상승하는 것으로 나타났다. 하지만 장기적인 균형관계를 보이고 있지 않았다. 가격이전효과에서는 위안화 환율개혁 이후부터 주식시장에서 외환시장으로 나타나고는 있지만 통계적으로 큰 의미를 찾을 수 없었고, 비대칭적 변동성이전효과에서는 위안화 환율기제 개혁이전에는 주식시장과 외환시장 상호 간 이전효과가 존재했지만 개혁 이후부터 주식시장에서 외환시장으로의 이전효과만 존재하는 것으로 나타났다. 즉, 주식시장의 음의 정보에 외환시장이 민감하게 반응하고 있는 것으로 나타났다. 결과적으로 이러한 분석결과로 볼 때, 향후 위안화 환율기제 변화에 대해 시장의 위험 발생 가능성은 낮은 것으로 추정할 수 있다. This paper investigates the dynamic relationship between China`s stock prices index and Rmb/Dollar exchange rate using the daily closing prices covered from January 4, 2000 to December 31, 2009. Based on VAR(Vector-Auto Regression) model the co-integration test is performed in order to measure long-term equilibrium relationship between two variables. In addition analyze causality between two variables using Impulse Response Function test. And applies E-GARCH(Exponential generalized ARCH) model, this paper tries to answer the question whether price and volatility spillover effect exist between stock markets and foreign exchange markets. The main empirical results are as follows. First, we found that there exist causal relationship from foreign exchange markets to stock markets for the post-RMB exchange rate regime reform period. And using the Co-integration test we found that there are no long-run equilibrium relationship between stock prices and exchange rates in this period. Second, EGARCH analysis shows that there are dynamic interdependence between foreign exchange markets and stock markets for the post-RMB exchange rate regime reform period. And regarding volatility spillover effect, our findings indicate that volatility spillover effect from stock markets to foreign exchange markets is asymmetric. Finally, based on the results, mechanism of RMB exchange rate changes that may occur as the potential risks of the market can be assumed that low.
한재진(Jae Jin Han),나찬영(Chan Young Rha),소동문(Dong, Moon Soh),이영탁(Young Tak Lee),서동만(Dong Man Seo),박표원(Pyo Won Park),박영관(Young Kwan Park),이영균(Yung Kyoon Lee),이홍재(Heung Jae Lee),최연현(Yeon Hyeon Choe) 대한흉부외과학회 1992 The Korean Journal of Thoracic and Cardiovascular Vol.25 No.4
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Purpose The purpose of this study was to assess die utility of multi-detector computed tomography with a patient position change for die diagnosis of esophageal cancer. Material and methods Sixty nine patients with esophageal cancer underwent computed tomography(CT) in supine and prone positions. CT scans were performed in supine position at first, and in prone position followed. CT images were evaluated for perception esophageal cancer, findings of paraesophageal infiltration and presence of paraesophageal lymphadenopathy. The detectabilities of esophageal cancer, paraesophageal infiltration and paraesophageal lymphadenopathy were evaluated on prone position CT and compared with those of supine position CT, by scoring systems(1-3). In addition, findings on were correlated with those on endoscopy and post operatetive findings. Results The mean score for detectability of esophageal carcinoma on prone position CT (2.58±0.7367) was higher than on supine position CT(2.42±0.829). The mean score for detectability of paraesophageal infiltration was higher on prone position CT(2.91±0.29) than on supine position CT(2.65±0.48). The mean score for detectabiliry of paraesophageal infiltration in patient with esophagectomy was higher on prone position CT(2.39±0.85) than on supine position CT(2.06±0.73). Conclusion Multi-detector CT with prone position has advantages for evaluation of esophageal cancer by improving deteaability of mass lesion and paraesophageal infiltration.